老年2型糖尿病患者颈动脉粥样硬化与血清护骨素水平的关系

发布时间：2018-08-26 09:26

【摘要】：目的:探讨血清护骨素(osteoprotegerin,OPG)水平与老年2型糖尿病患者颈动脉粥样硬化发生、发展的关系。OPG是否为老年2型糖尿病患者颈动脉IMT增厚、狭窄发生的独立危险因素。方法:选取山西医科大学第二临床医院就诊的老年2型糖尿病患者143例,用彩色多普勒超声检查结果将受试者根据颈动脉内膜中层厚度(IMT)水平分为IMT正常组36例,IMT增厚组107例;又根据颈动脉是否有狭窄分为颈动脉无狭窄组109例,颈动脉狭窄组34例。所有受试者统一测定各项生化指标(包括空腹血糖、糖化血红蛋白、甘油三酯、总胆固醇、高密度脂蛋白、低密度脂蛋白及尿酸),血清OPG水平用酶联免疫吸附实验(ELISA)统一检测。结果:IMT增厚组年龄、糖尿病病程、SBP、DBP、空腹血糖、糖化血红蛋白、尿酸及血清OPG明显高于IMT正常组。颈动脉狭窄组年龄、糖尿病病程、高血压病史、空腹血糖、糖化血红蛋白、尿酸及血清OPG明显高于颈动脉无狭窄组。IMT增厚组与IMT正常组在年龄、尿酸及血清OPG水平比较差异有统计学意义(P㩳0.05),颈动脉狭窄组与颈动脉无狭窄组血清OPG水平、尿酸比较差异有统计学意义(P㩳0.05)。老年2型糖尿病患者颈动脉IMT增厚组血清OPG水平与血总胆固醇(r=0.196,P=0.044)、低密度脂蛋白(r=0.213,P=0.028)呈正相关,与糖尿病病程(r=-0.320,P=0.001)负相关;老年2型糖尿病患者颈动脉狭窄组血清OPG水平与糖化血红蛋白水平(r=0.366,P=0.033)、空腹血糖(r=0.362,P=0.35)呈正相关。logistic回归分析显示,OPG、尿酸为颈动脉狭窄发生的危险因素(OR=1.011,95%CI:1.006-1.016,P=0.000),(OR=1.010,95%CI:1.004-1.016,P=0.002)。结论:老年2型糖尿病患者,OPG升高与颈动脉粥样硬化密切相关,是颈动脉粥样硬化发生的危险因素。
[Abstract]:Objective: to investigate the relationship between serum osteoprotegerin (osteoprotegerin,OPG) level and carotid atherosclerosis in elderly patients with type 2 diabetes mellitus. Methods: 143 elderly patients with type 2 diabetes mellitus were selected from the second Clinical Hospital of Shanxi Medical University. According to the (IMT) level of carotid intima-media thickness, the subjects were divided into 36 cases of normal IMT group and 107 cases of IMT-thickening group. According to the carotid artery stenosis, 109 cases were divided into carotid artery stenosis group (109 cases) and carotid artery stenosis group (34 cases). The biochemical indexes (including fasting blood glucose, glycosylated hemoglobin, triglyceride, total cholesterol, high density lipoprotein, low density lipoprotein and uric acid) and serum OPG were determined by enzyme linked immunosorbent assay (ELISA). Results the age, duration of diabetes, fasting blood glucose, glycosylated hemoglobin, uric acid and serum OPG were significantly higher in the thickening group than those in the normal IMT group. Age, course of diabetes, history of hypertension, fasting blood glucose, glycosylated hemoglobin, uric acid and serum OPG in carotid artery stenosis group were significantly higher than those in carotid artery stenosis group and normal IMT group. The levels of uric acid and serum OPG were significantly different (P0. 05). The levels of serum OPG and uric acid were significantly different between carotid stenosis group and no carotid artery stenosis group (P0. 05). In elderly patients with type 2 diabetes mellitus, the level of serum OPG in carotid IMT thickening group was positively correlated with serum total cholesterol (r = 0.196 P0. 044), low density lipoprotein (r = 0.213), and negatively correlated with the course of diabetes (r = -0.320, P0. 001). The levels of serum OPG and glycosylated hemoglobin (RHG) were positively correlated with glycosylated hemoglobin (RHG) and fasting blood glucose (RG0.362P0. 35) in elderly type 2 diabetic patients with carotid artery stenosis. Logistic regression analysis showed that serum OPG and uric acid were risk factors of carotid artery stenosis (OR=1.011,95%CI:1.006-1.016,P=0.000), (OR=1.010,95%CI:1.004-1.016,P=0.002). Conclusion: the increase of OPG in elderly patients with type 2 diabetes is closely related to carotid atherosclerosis and is a risk factor for carotid atherosclerosis.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R587.2

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